Medicalizing People -- and Mongering Diseases

Feb. 23, 2007 — -- The title of my monograph, "The Last Well Person" was borrowed (with his enthusiastic encouragement) from Clifton Meador.

In 1994, Meador published an essay in the New England Journal of Medicine in which he described a 53-year-old academic whose symptoms defy diagnosis despite extensive medical investigation. No other person in this brilliant parody is said to have escaped diagnosis.

Today, it's no longer a parody.

We are a country of obese, hypercholesterolemic, hypertensive, diabetic, osteopenic, depressed, pitiful creatures perched on the edge of a cliff staring at condors: cancer, heart attacks, strokes, dementia, fractures, and worse. We fear for our future. We teach our children that they, too, must live in fear for their future.

We mobilize all our courage when faced with creakiness, achiness, heartburn and heartache, headache and bellyache, constipation or diarrhea, impotence, sleeplessness, and even restless legs. No infant can simply be fussy and no child can simply be fidgety, obstreperous, or below average in performance. We are told that all these are symptoms of disease, or harbingers. We are a vigilant society.

We are also a modern people blessed by remedies. For us, mortality is an abstraction, a formless beast that we can bring to heel by the determined application of the latest and most convincing scientific insights.

All daunting, unpredictable challenges to our sense of well being can yield to a canny choice of ministration. We exalt our modern scientific medicine; our forefathers had but sages, often religious sages, pointing to the path to a good life, if not a longer life.

Today we wait, breath bated, for the next pronouncements of the biomedical establishment. Nearly all in our personal, intimate life that is untoward is now under their purview.

How are we to know if we are well, or still well? We are bombarded by the print and broadcast media with the scare of the week. We are bombarded by purveyors with the cure of the weekend.